Physical Exams for Egg Donors
Most American recipient couples place a great deal of importance on emotional, physical, ethnic, cultural and religious compatibility with their chosen ovum donor. However, it is essential to emphasize the fact that THERE IS NO PERFECT DONOR. The recipient will not find themselves/their spouse in the egg donor. Therefore, the couple should not lose sight of the objective, which is to have a family. A general physical likeness, good health, and satisfactory screening provide a good clinical safety record for recipients.
Assessing the OD’s ovarian responsiveness: Assessing an individual’s follicle recruitment potential is accomplished by measuring FSH and E2(estradiol) on the 3rd day of a spontaneous menstrual cycle. We may request a serum Inhibin level. An FSH of less than 8.0 mIU/ml in association with a plasma estradiol concentration between 20 and 60 pg/ml and an Inhibin B level above 45 ng/ml usually points to the woman being a potentially good responder to gonadotropin stimulation. However, recipients must be made aware of the possibility of a suboptimal ovarian response in spite of these tests all being within normal limits. Other measurable hormonal parameters include TSH; free T4 and prolactin which if present in a high concentration can reduce ovarian response to gonadotropins.
ASRM guidelines recommend that all ovum donors be tested for sexually transmittable diseases before entering into a cycle of IVF. It is highly improbable that DNA and RNA viruses are vertically transmitted to an egg or an embryo through sexual intercourse or IVF. Nevertheless the albeit remote possibility as well as the legal consequences of the ovum donation process being blamed for an unrelated occurrence of disease states such as hepatitis B, C or HIV such disease states, demands that potential donors so infected be disqualified from participating in IVF with ovum donation. In addition, evidence of prior or existing infection with chlamydia or gonorrhea introduces the possibility that the ovum donor so affected might have pelvic adhesions or even irreparably damaged fallopian tubes that might have rendered her infertile. As previously stated such infertility, subsequently detected might be blamed on infection that occurred during the process of egg retrieval, exposing the caregivers to litigation.
Genetic screening have already alluded to the need for appropriate history taking so as to identify hereditary disorders that can be transmitted via the egg, to the offspring. As stated, ASRM guidelines require selective testing for certain conditions such as cystic fibrosis.